Sudden Death Syndrome

   Just prior to the 2012 Olympics, a Norwegian world champion and Olympic medal winning swimmer dropped dead in a bathroom from cardiac arrest. Also around that time, a pro soccer player in England keeled over from a heart attack during a game. Luckily, he survived. A Detroit Red Wings hockey player survived a similar cardiac event during a game. A top American marathoner dropped dead during the 2008 Olympic Trials. Jim Fixx, a famous running guru and running author, died from heart failure while out on a run.  These people were all outwardly healthy and fit athletes.
 
   More inactive people die from cardiac and pathological events than active people. While such occurrences with active people are rare, they are also frightening! How is this a concern for Fitness Trainers? Having a client drop on you can be shocking! Having a client die on you could be a career breaker!  If it can happen to an elite athlete then it could happen to your client. I know a running expert/trainer who was advising a woman client. While he was away on holidays she passed away. It most likely had nothing to do with him but it could easily had happened during one of his workout sessions thus putting him in a dangerous light!
A close friend of mine finished some chores, took an afternoon nap and never woke up. He was my age. He had never had any obvious health problems.
   Hidden conditions of concern include:

• Heart abnormalities such as murmurs, valve issues, and overly thickened heart walls.
• Aneurysms and weakened blood vessel walls.
• Potential blockages of blood flow to the heart or brain.

   Even if you have protected yourself with insurance and a waiver, you don't want such an incident to occur under your watch. Your reputation could be history even if it was just a tragic fluke of genetics.
   How can you lessen the risk? Always screen clients thoroughly! Failure to properly screen is negligence. You want to determine the possibility of hidden heart defects. Use the following procedural tools:

1. Verbal consultation. Discuss health and lifestyle history. The client may admit to to a heath concern that wouldn't come out in the open with just filling out forms.
2. The Par-Q form. If the client checks the 'yes' box of any question,  refer the client to a doctor along with giving them a Par-Med-X form. The doctor can screen the client or clear them with  certain conditions attached.
3. Check blood pressure and heart rate. Readings above 144 systolic or 94 diastolic could be due to underlying pathological concerns. Resting heart rates above 100 beats per minute are also reasons for screening. An initial high reading for BP or HR may be only due to anxiety. However consistently high readings should be a matter of concern.
4. Administer some type of sub-maximal aerobic test.  Any abnormal heart rate reading should be a red flag! If the client fails to physically recover in a timely manner that should also be a red flag!

   If in doubt,.....REFER TO A DOCTOR !!!!!  A physician can test a referred client with an electrocardiogram or other diagnostic tools to discover any cardiac issues or physiological concerns. The doctor can then make recommendations for exercise. Some types of cardiovascular irregularities may still slip  through the screening process undetected.  However, at least the risks can be lessened.
   If somehow, despite your stringent screening process, your client still has what appears to be a cardiac or emergency event during one of your sessions you must act with extreme authority. Avoid panic and follow rehearsed scenarios:

• Initiate the emergency protocol at the fitness center where you operate. This should be known beforehand and arranged with fitness center staff. Emergency services must be called whatever the situation. If you work out in an outside environment, carry a cell phone to call emergency services. If you visit clients at their home for training or have your own studio, have a working phone accessible.
• You must have your CPR and Automatic External Defibrillator training current. If the fitness center you work out of has no defibrillator,  pester them to get one. If you have your own fitness studio, a defibrillator is a wise investment. It would be a tax deductible business expense.

   Pray for the best but prepare for the worst.You want your client breathing hard after your training regime, but still breathing.

   Just before Christmas last year a Canadian Greco Roman wrestling champion died suddenly in bed. This athlete was superbly fit and Herculean in strength but some undetected physiological condition may have been lurking. He was only 25 years old. That does not mean that his extremely intense lifestyle hastened his passing. It may have happened no matter what.

Fortunately such sudden death episodes rarely if ever happen during an Olympics.
There are enough risks and hazards at this years Winter Olympics along with the security concerns.
Let's pray that the only sudden death event that occurs will be the gold medal hockey game.
  
In a perfect health care system every citizen would be tested thoroughly early in life for any potential conditions. Then preventive medicine or precautionary lifestyle measures could be put in place. Unfortunately this could  prove to be too costly and too inconvenient to ever become a reality in any society. It would be awesome if it was!

 I would like to conclude with a few excerpts from a poem I memorized in Grade 9 English class. The poem is  "To an Athlete Dying Young" by A.E. Houseman

The time your won you town the race              

Sudden death syndrome leaves a shocking void.
See you all on the other side!

We chaired you through the market place
Man and boy stood cheering by
And home we brought you shoulder high

Today the road all runners come
Shoulder high we bring you home
And set you at your threshold down
Townsmen of a stiller town 

Eyes the shady night has shut
Cannot see the record cut
And silence sounds no worse than cheers
After earth has stopped the ears

Now you will not swell the rout
Of lads that wore their honours out
Runners whom renown outran
And the name died before the man

Until next time,.......keep fit!

Little Bobby Strong

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